Please use the <Edit Contents> menu option (directly above) to complete this form. Remember to <Save> the page (bottom right) after making updates. Other than the two required fields immediately below, you may complete any portion of this form, save, and return later to continue where you left off.

Trip Proposals must be completed at least six (6) weeks before the event start date.

Person Completing Form
Name:Glenn McKnightDate:

01-Mar-2016

STAFF USE ONLY
Application
Status 
Assessment
Due-Date 
Form ID #
APPROVED

01-Jul-2016

NA07

Trip Proposal Section

LINK: NARALO Trip/Event Assessment 7

1) Number of Travelers:
(Note: Each traveler uses one trip of the five (5) allocated to each organization/structure).  

1

2) Traveler Contact Information and Itinerary:

TravelerEmailFrom
City
From
Country
Depart
Date
Return
Date
John Laprisejlaprise@gmail.comChicagoUSA08-Jun-201610-Jun-2016
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
No special requirements: Conference fee of $595, hotel accommodations, round trip airfare Chicago-New York: https://personaldemocracy.com/product/personal-democracy-forum-2016-registration
4) Event/Conference Name, Title, or Descriptor:Personal Democracy
5) Event/Conference Dates:
Start:08-Jun-2016End:09-Jun-2016
6) Event/Conference Website Link:https://personaldemocracy.com/product/personal-democracy-forum-2016-registration
7) Primary Event/Conference Location:
Street
Address:
NYU Skirball Center New York City, NY
City:New YorkCountry:USA
8) ICANN Geographic Region:North America

9) Activity Sponsors:
(Note: all event sponsors must be identified
in order to comply with ICANN travel guidelines).


The event is sponsored by Microsoft. It's parent organization is sponsored by Microsoft, Google, and the Omidyar Network.

10) Proposed Goals and Outcomes:

The primary goals/outcomes of attending this conference are twofold: first to raise awareness of NARALO and ICANN in the context of the personal democracy movement which is at it's heart dependent upon the Internet; and second to return back to NARALO inputs from users outside the organization to enrich our insights and enable us to make better policy contributions within the Internet governance ecosystem.
11) Additional Information (optional):

======================================= 
Community Confirmation Section

Note: To be completed by a Pilot Program Coordinator (PPC) designated by this organization/structure.

AcknowledgementsConfirmed?NameDateNotes
The participants identified in this application agree to abide by the terms and conditions of this FY16 Community Regional Outreach Pilot Program (CROPP) as outlined on the Program Elements page. YesGlenn McKnight17-Mar-2016
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.YesAllan Skuce01-Apr-2016Authorized and Approved
The ICANN Stakeholder Engagement Vice-President has concurred that the Proposed Goals/Outcomes of this Trip Proposal are consistent with operational plans and/or strategies.YesAllan Skuce01-Apr-2016Approved. Complete
  =======================================================
Program Administration: STAFF USE ONLY

Approved Travel Elements:

TravelerApproved
Arrival Date
Approved
Departure Date
Approved Fees 
John Laprise08-Jun-201610-Jun-2016

Airfare
Hotel/Lodging
Per Diem
Registration

Staff Department Notifications:

Program RequirementDate Satisfied/ConfirmedInitialsNotes
Constituency Travel Notified05-Apr-2016JDLConference fee of $595

Program Admin Transfers from Community Drafts to Approved Forms:

Trip Proposal07-Apr-2016Trip/Event Assessment21-Jul-2016


CROPP Trip Proposal Template v4 (Aug 2015)

For comments, suggestions, or technical support concerning this space, please email: CROPP Program Staff
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